Korábbi változatok

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My quick take was to distinguish Recommendation from Decision Rule and see what is missing for the computable expression (precise, unambiguous, machine-interpretable expression) of the Recommendation component.   On a quick view of PlanDefinition Resource the “action(s)” appear really well specified so it appears the “whenToAct” specification is what is not easily translated from the guideline recommendation statement to the later expression.  If there is an easy path for doing that let’s use it.  If there are adjustments to make the path easy, let’s do it.  If not then perhaps a Recommendation Profile is a way to make this easier.

Response [Excerpt] from Matt Burton (Lead for C19HCC Digital Guideline WG):

The HL7 CPG IG is not first and foremost CDS, its very much intended to be a computer-interpretable expression of the guideline itself; then with: 1) the means to derive highly related artifacts such as ECA-Rule-based CDS, patient-specific, practice-level metrics that *may* be rolled up into Quality Measures, eCaseReports to provide all the detail of guideline ‘execution’ at the patient-level (when they met criteria for a recommendation, when CDS notified the clinician of the proposed action, when/if clinicians took said action [order/request], when said proposal or request was fulfilled [whether evidence of request or not], any desired metrics that were captured and how they may have evolved over time [e.g. “on/off path”, “on with a history of off”], and any provider Impressions that may qualify any of the afore mentioned); and 2) lots of human consumable narrative on how to implement an HL7 CPG across its entire lifecycle (from working with Guideline Developers & the Evidence Ecosystem to working with local Practices and their informatics and EHR teams, and numerous other ecosystem touchpoints between- not the least of which is getting the data semantics as applied in point of care clinical information systems nailed- not just a bunch of terms hurled at ehr’s).  Not sure if it is the name, the specification, how we have presented it to date, or some other factor, but that the HL7 Clinical Practice Guideline Implementation Guide describes the process and patterns that afford the means to computationally express the intent of the guideline is a point oft missed.